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We end the week with an intentionally provocative question: Have we gotten EHRs all wrong?

The “we” in that question refers to the array of policymakers and stakeholders that have been developing and promoting EHRs for the past several years. And the question itself comes in response to this Texas doctor who blogs fairly regularly on, among other things, health IT.

He begins with a history lesson concerning how the internet worked during the 1980’s and 1990’s, then points to Facebook as a prime example of how far the world has come.

And EHRs? That’s right, they’re much closer to the internet model of old. As he puts it, “The similarities between modern EMRs and the BBS system are striking. Like many old Bulletin Board Systems the vast majority of EMR systems do not communicate with each other (nor even the outside world). Not only are they often incapable of communicating with another EMR or computer but even in 2012 most new EMRs don’t even have an option for sharing information with other systems! This is one of the biggest paradoxes and failures of almost all EMRs. Designed for an industry where the sharing of medical information among different facilities and health care providers is critical to the timely, effective, and safe delivery of medical care, the majority of these systems are designed to share information only within the limited confines of the specific facility or health care system that they serve. EMRs are essentially information islands cut off almost completely from direct contact with the rest of the interconnected world.”

But technology is only the product of the mentality behind it. And in his view, “the majority of health care facilities and health care providers still think about medical records the same way they did 100 years ago – as property or proprietary information. A physical medical chart is considered to be the property of the facility or provider who generated the chart even though the patient is considered to be the “owner” of the information contained within the chart.”

The piece is definitely worth reading in its entirety, as is a follow-up post in which he lays out what he sees as steps for solving the problem. And then let us know what you think.

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Tom Tsang, MD, Aaron McKethan, PhD, and Craig Brammer from the Office of the National Coordinator, and the Beacon Communities give an overview of the Beacon Community Program in this video from the ONC website.